Joint and muscle pain from hormone therapy for breast cancer

You may get joint pain and sometimes muscle pain if you:

• take an aromatase inhibitor (AI) (such as anastrozole, letrozole and exemestane)
• are having, or have had, ovarian suppression (drugs to stop the ovaries working or surgery to remove the ovaries).

Joint pain is probably caused by a decrease in oestrogen levels. It is also a common symptom of the menopause.

Pain is most common in the hands and feet, but can also happen in the knees, hips, lower back and shoulders. You may have it all the time or it may come and go. You may notice that your joints are stiffer in the morning, when you first get up.

If you have recently started taking an aromatase inhibitor, the pain may get better over the next few months. This may happen as the body adjusts to changes in hormone levels. Aromatase inhibitors are very good at reducing the risk of breast cancer coming back.

You should not stop taking your treatment without talking to your cancer doctor. There is usually something that can be done to improve pain.

Talk to your doctor

It is important to talk to your cancer doctor or specialist nurse if joint or muscle pain is a problem for you. Your doctor can prescribe drugs to help control the symptoms and find other ways of improving them.

See a physiotherapist

If you are having lots of problems with pain, your cancer doctor can refer you to a physiotherapist. They can give you more advice and treatment.

See an occupational therapist

If you are having difficulty doing daily tasks, you can also ask to be referred to an occupational therapist (OT). They will be able to assess your needs and suggest aids and equipment to help you.

Keep active

Try doing regular exercise to strengthen the muscles around your joints. This can help to keep them flexible and reduce pain. Some types of exercise may feel more comfortable than others. These include non-weight-bearing exercises, such as swimming and cycling.

Ask your doctor about complementary therapies

Acupuncture may help to reduce pain from joint symptoms. Some local charities may offer free acupuncture. Sometimes it may be available on the NHS, but this is not common. The needles should not be used on the arm of the affected side.

Complementary therapies such as massage may be helpful for some people. Some hospitals offer massage on the NHS.

It is very important to talk to your cancer doctor or specialist nurse before starting complementary therapies. They can talk to you about any possible harmful impacts these could have on your cancer treatment, and about any possible side effects.